Healthcare Provider Details

I. General information

NPI: 1609704535
Provider Name (Legal Business Name): EMILY MADISON GARRAGHTY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2212 CENTERVILLE RD
BEDFORD VA
24523-4208
US

IV. Provider business mailing address

2212 CENTERVILLE RD
BEDFORD VA
24523-4208
US

V. Phone/Fax

Practice location:
  • Phone: 540-875-8696
  • Fax: 540-875-8696
Mailing address:
  • Phone: 540-875-8696
  • Fax: 540-875-8696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0704018886
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: